Ganong's Review of Medical Physiology, 23rd Edition

(Chris Devlin) #1
CHAPTER 31
The Heart as a Pump 509

EARLY DIASTOLE


Once the ventricular muscle is fully contracted, the already
falling ventricular pressures drop more rapidly. This is the pe-
riod of
protodiastole,
which lasts about 0.04 s. It ends when
the momentum of the ejected blood is overcome and the aortic
and pulmonary valves close, setting up transient vibrations in
the blood and blood vessel walls. After the valves are closed,
pressure continues to drop rapidly during the period of
iso-
volumetric ventricular relaxation.
Isovolumetric relaxation


ends when the ventricular pressure falls below the atrial pres-
sure and the AV valves open, permitting the ventricles to fill.
Filling is rapid at first, then slows as the next cardiac contrac-
tion approaches. Atrial pressure continues to rise after the end
of ventricular systole until the AV valves open, then drops and
slowly rises again until the next atrial systole.

FIGURE 31–1
Divisions of the cardiac cycle: A) systole and B) diastole.
The phases of the cycle are identical in both halves of the heart.
The direction in which the pressure difference favors flow is denoted by an arrow; note, however, that flow will not actually occur if valve prevents it.


SystoleA

B

Blood flows out of ventricle

Ventricles
contract

Atria
relaxed

Ventricles
relaxed

Atria
relaxed

Ventricles
relaxed

Atria
relaxed

Ventricles
relaxed

Atria
contract

Ventricles
contract

Atria
relaxed

Closed

Closed Closed

Open

Diastole

Blood flows into ventricles

Atrial contraction

AV valves:
Aortic and
pulmonary valves:

Closed

Closed Open

Closed

Open

Closed

AV valves:
Aortic and
pulmonary valves:

Isovolumetric ventricular contraction

Isovolumetric ventricular relaxation

Ventricular ejection

Ventricular filling
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